Abstract
BackgroundSymptomatic osteoarthritis (OA) affects approximately 10% of adults aged over 60 years. The foot joint complex is commonly affected by OA, yet there is relatively little research into OA of the foot, compared with other frequently affected sites such as the knee and hand. Existing epidemiological studies of foot OA have focussed predominantly on the first metatarsophalangeal joint at the expense of other joints. This three-year prospective population-based observational cohort study will describe the prevalence of symptomatic radiographic foot OA, relate its occurrence to symptoms, examination findings and life-style-factors, describe the natural history of foot OA, and examine how it presents to, and is diagnosed and managed in primary care.MethodsAll adults aged 50 years and over registered with four general practices in North Staffordshire, UK, will be invited to participate in a postal Health Survey questionnaire. Respondents to the questionnaire who indicate that they have experienced foot pain in the preceding twelve months will be invited to attend a research clinic for a detailed clinical assessment. This assessment will consist of: clinical interview; physical examination; digital photography of both feet and ankles; plain x-rays of both feet, ankles and hands; ultrasound examination of the plantar fascia; anthropometric measurement; and a further self-complete questionnaire. Follow-up will be undertaken in consenting participants by postal questionnaire at 18 months (clinic attenders only) and three years (clinic attenders and survey participants), and also by review of medical records.DiscussionThis three-year prospective epidemiological study will combine survey data, comprehensive clinical, x-ray and ultrasound assessment, and review of primary care records to identify radiographic phenotypes of foot OA in a population of community-dwelling older adults, and describe their impact on symptoms, function and clinical examination findings, and their presentation, diagnosis and management in primary care.
Highlights
Symptomatic osteoarthritis (OA) affects approximately 10% of adults aged over 60 years
Symptomatic osteoarthritis (OA) is common in the general population, affecting the daily lives of an estimated 10% of people aged over 60 years [1]
Symptomatic foot OA is a common problem, yet is under-researched relative to other sites commonly affected by OA, such as the knee and hand [6]
Summary
Symptomatic osteoarthritis (OA) affects approximately 10% of adults aged over 60 years. Existing epidemiological studies of foot OA have focussed predominantly on the first metatarsophalangeal joint at the expense of other joints. This three-year prospective population-based observational cohort study will describe the prevalence of symptomatic radiographic foot OA, relate its occurrence to symptoms, examination findings and life-style-factors, describe the natural history of foot OA, and examine how it presents to, and is diagnosed and managed in primary care. Symptomatic osteoarthritis (OA) is common in the general population, affecting the daily lives of an estimated 10% of people aged over 60 years [1]. The recent publication of a validated atlas for scoring OA at the 1st MTPJ and at the 1st and 2nd cuneo-metatarsal joints (CMJ), the navicular-1st cuneiform joint (NCJ) and the talo-navicular joint (TNJ) [24] provides a basis for investigating patterns of radiographic foot OA, and their relation to impairment (e.g. pain and deformity), activity limitation and participation restriction
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